Clinical Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Ljubljana, Slovenia.
Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Diabetes Technol Ther. 2019 Oct;21(10):566-574. doi: 10.1089/dia.2019.0131.
Integrative diabetes care is lifelong and encompasses patient-reported outcome measures (PROMs). Understanding older adults' perceptions of continuous glucose monitoring (CGM) benefits and potential annoyances is important to assist with introducing it in this population. The aim of this study was to investigate PROMs and effectiveness of CGM introduction in elderly multiple daily injection (MDI) users with well-controlled diabetes. MDI-treated elderly ( = 25, mean age 67.6 ± 1.2 years, HbA1c = 7.1% ± 0.2%, 56% type 1 diabetes) were instructed to use a CGM device. PROMs were measured by questionnaires. CGM-recorded glycemic control metrics (time in range [TIR], time in hypoglycemia, coefficient of variation [CV]) were compared during blinded CGM and real-time CGM. Satisfaction with CGM use was high; with perceived advantages as "very common" (4.22 out of 5) and annoyances as "modest" (1.82 out of 5). In total 95% of participants expressed improved sense of security with CGM use, 68% reported of improved sleep quality, and 82% were willing to use a CGM device after finishing the study protocol. CGM introduction did not impose additional diabetes-related distress (measured by the Problem Areas in Diabetes questionnaire). Significant improvements in TIR (3.9-10.0 mmol/L) (66.3% ± 2.6% vs. 76.9% ± 3.0%; < 0.001), time in hypoglycemia (9.6% ± 2.1% vs. 5.2% ± 1.1%; = 0.041), as well as reduced glycemic variability (%CV) (37.3 ± 11.1 vs. 32.9 ± 6.3; < 0.001) were observed. Introduction of CGM in elderly patients with well-controlled diabetes resulted in high satisfaction without imposing additional diabetes distress. Furthermore, an added benefit in glucose control with stabilizing glycemia in target range was proven.
综合糖尿病管理是终身的,包括患者报告的结局测量(PROMs)。了解老年人对连续血糖监测(CGM)益处和潜在烦恼的看法,对于帮助该人群引入 CGM 非常重要。本研究旨在调查接受多次每日注射(MDI)治疗的血糖控制良好的老年糖尿病患者中 PROMs 和 CGM 引入的效果。指导 MDI 治疗的老年患者(n=25,平均年龄 67.6±1.2 岁,HbA1c=7.1%±0.2%,56%为 1 型糖尿病)使用 CGM 设备。通过问卷测量 PROMs。在盲法 CGM 和实时 CGM 期间比较 CGM 记录的血糖控制指标(TIR、低血糖时间、变异系数[CV])。CGM 使用满意度高;感知优势为“非常常见”(5 分制 4.22 分),烦恼为“适度”(5 分制 1.82 分)。总共有 95%的参与者表示使用 CGM 后安全感提高,68%报告睡眠质量改善,82%愿意在完成研究方案后使用 CGM 设备。CGM 引入不会增加与糖尿病相关的困扰(通过糖尿病问题领域问卷测量)。TIR(3.9-10.0mmol/L)显著改善(66.3%±2.6%比 76.9%±3.0%; <0.001),低血糖时间(9.6%±2.1%比 5.2%±1.1%; =0.041)以及血糖变异性(%CV)降低(37.3±11.1比 32.9±6.3; <0.001)。在血糖控制良好的老年糖尿病患者中引入 CGM 后,满意度高,且不会增加糖尿病相关困扰。此外,还证明了在目标范围内稳定血糖的血糖控制方面有额外的获益。